Prestige One Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRESTIGE ONE MEDICAL SUPPLY

Practice address

1108 Gulf Fwy S
Suite #270
League City, TX 77573-5100

Phone

(713) 893-3073

NPI assigned

Mar 8, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Corey Jamal Johna

Title

Owner/Cfo

Phone

(281) 543-5649

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1720529852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 GULF FWY S",
            "address_2": "SUITE #270",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735100",
            "telephone_number": "713-893-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 GULF FWY S",
            "address_2": "SUITE #270",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735100",
            "telephone_number": "713-893-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE ONE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "JOHNA",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "JAMAL",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "281-543-5649",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in League City, TX
• Providers in League City, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.